Influence of Specific Health Guidance on the Consultation Rate of Metabolic-Related Diseases

Table 7

The specific health checkups standard questionnaire.

	Questions	Answer choices
Q1-3	Are you currently taking the following medications?	Yes / No
	(1) a medicine to lower blood pressure	Yes / No
	(2) insulin injections or a medicine to lower blood glucose	Yes / No
	(3) a medicine to lower cholesterol	Yes / No
Q4	Have you ever been told by a doctor that you have stroke (e.g., cerebral hemorrhage, cerebral infarction) or have you ever received treatment for stroke?	Yes / No
Q5	Have you ever been told by a doctor that you have heart disease (e.g., angina, myocardial infarction) or have you ever received treatment for heart disease?	Yes / No
Q6	Have you ever been told by a doctor that you have chronic renal failure or have you ever received treatment for chronic renal failure (dialysis)?	Yes / No
Q7	Have you ever been told by a doctor that you have anemia?	Yes / No
Q8	Are you a current regular smoker?; (※A “current regular smoker” is a person who has smoked a total of 100 or more cigarettes or smoked for 6 months or longer and has been smoking for the last 1 month.)	Yes / No
Q9	Have you gained ≥10 kg since you were 20 years old?	Yes / No
Q10	Have you been exercising for 30 minutes or more each at an intensity that causes a slight sweat, 2 days or more every week, for at least 1 year?	Yes / No
Q11	Have you been exercising such as walking or equivalent more than 1 hour everyday in your daily life?	Yes / No
Q12	Do you walk faster than people of your age and sex?	Yes / No
Q13	Have you had a weight gain or loss of ≥3 kg over the last year?	Yes / No
Q14	How fast do you eat compared to others?	Faster / Normal / Slower
Q15	Do you have an evening meal within 2 hours before going to bed 3 days or more every week?	Yes / No
Q16	Do you have snacks (nights meals in addition to 3 daily meals) after the evening meal 3 days or more every week?	Yes / No
Q17	Do you skip breakfast 3 days or more per week?	Yes / No
Q18	How often do you drink alcohol (sake, shochu [distilled spirits], beer, liquor, etc.)?	Everyday / Sometimes / Rarely (can't drink)
Q19	How much do you drink a day, in terms of glasses of refined sake? (A glass 180 mL] of refined sake is equivalent to a medium bottle 500 mL] of beer, 80 mL of shochu (alcohol content 35 percent), a glass [double, 60 mL] of whiskey, and 2 glasses 240 mL] of wine.)	① <1 ② ≥1 and <2; ③ ≥2 and <3 ④ ≥3
Q20	Do you feel refreshed after a night’s sleep?	Yes / No
Q21	Are you going to start or have you started lifestyle modifications (e.g., increase physical activity, improve dietary habit)?	① No plan to improve.; ② I’m going to start in the future; (e.g., within 6 months).; ③ I’m going to start soon; (e.g., in a month), or; I have just started some of them.; ④ I already started; (<6 months ago).; ⑤ I already started; (≥6 months ago).
Q22	Are you willing to have Health Guidance about lifestyle modifications if the opportunity arises?	Yes / No